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Argentina: unusual serious cases in young people

Re: Argentina: unusual serious cases in young people

Recursos para m?dicos


Directrices para las audiencias espec?ficas


Ni?os




Mujeres embarazadas




VIH




Vea Informaci?n general
Vea Recursos para padres y quienes se encargan del cuidado de otras personas
Vea Recursos para mujeres embarazadas
 
Re: Argentina: unusual serious cases in young people

As Country Votes, Argentina on Verge of Declaring Swine Flu "Emergency"
Argentine health authorities said Saturday that a "health emergency" could be declared nationwide after elections on Sunday because of the exponential spread of the AH1N1 flu virus, which up till now has taken 26 lives and has infected 1,587 people. Meanwhile, health organizations said that the number of people infected in the country "is substantially greater" than the official toll and that hospitals are "verging on collapse"


Influenza_gen.jpg
BUENOS AIRES -- Argentine health authorities said Saturday that next week a "health emergency" could be declared nationwide because of the progress of the AH1N1 flu virus, which up to now has taken 26 lives and has infected 1,587 people.

"The emergency does not mean we're closing everything down, the emergency is a frame of reference for having medicines ready for direct purchase and mobilizing health personnel," said Claudio Zin, health minister in Buenos Aires province where the greatest number of deaths and infections have been recorded.

Zin said that this alert, which doctors' organizations have requested for days, "is a frame of reference for taking quick decisions" to combat the illness.

"It doesn't mean we're going to close schools and shopping malls and suspend transport on the metro," because "that's not the point," he said.

A different approach from that taken in Mexico City where, at the height of the epidemic, leisure and entertainment locations were shuttered along with part of the capital's 35,000 restaurants.

Schools were closed nationwide for 10 days and normally bustling Mexico City became a ghost town as people were urged to stay home to halt the spread of the illness.

The Buenos Aires health minister has, however, confirmed comments by members of the "crisis committee" created by the Argentine government to deal with the new flu virus, who say that the possibility of declaring a national emergency next week after this Sunday's legislative elections is being considered.


Graciela%20Oca
In "areas at risk" of contagion, "alcohol in gel and pads" are being distributed for wetting the finger used for sticking shut vote envelopes without using saliva, election official Alejandro Tullio said Friday.

To the prevention measures that authorities are recommending to the public, Tullio added that voters ought to "keep their distance one from the other in case people line up to vote and they should go to the polls early to avoid the crowds."

Health organizations said that the number of people infected in the country "is substantially greater" that the official toll and that hospitals are "verging on collapse."

The total number of deaths in Argentina from the swine-flu virus reached 26 on Friday, when three new fatalities were confirmed along with 99 new cases of the illness, raising the total to 1,587.

The Health Ministry said in a communique that under study are specimens from 967 people suspected of having caught the AH1N1 flu virus.

http://www.laht.com/article.asp?ArticleId=338061&CategoryId=12394
 
Re: Argentina: unusual serious cases in young people

colormyquilt said:


Thanks, Dark Horse. I have a question. What is it "about the details that would scare us...cause us to panic?"
Click to expand...

After reading the "lungs-on-fire" translation and internal organs destroyed description from Argentina's doctors on the front line, I feel my heart beat faster. I get scared. Is this something new that the virus is doing? Or is this simply what it has been doing all along, but in keeping with the "mild" mantra embraced by the media in the U.S. and Canada we infrequently hear about. Perhaps the Argentina doctors are simply being candid whereas the North American public health bureaucracies do not feel they can talk freely because of 1) HIPPA-type constraints, or 2) they are so entrenched in their "it's mild" risk communications mantra, that they willfully refuse to tell the truth.

Of course, the fluwatchers look for the new virus' adaptation to its human host which would likely produce more severe infections and more deaths. And I watch closely, read about each death, and still have absolutely no idea about whether this flu is becoming more lethal. I understand how HIPPA makes public officials very conservative about the information they reveal, but why doesn't CDC or some other medical group provide insight about these fatal cases that doesn't compromise the privacy of the deceased so that the public can understand what is really going on around the world?

My only guess is that the groups that are in a position to suspect on the basis of epidemiology that this virus is becoming more lethal as it spreads to larger populations are not interested in sharing that information.
 
Re: Argentina: unusual serious cases in young people

Dark Horse. The "lungs-on-fire" hit home for me, too; I have had pneumonia three times. Respiratory is apparently my weakness. :)


What I hear you hitting at, again and again, is the unknown re: the lethality and the death rate. Also, that there is a lot more information out there than appears to be provided to the public in general.

What information could be given now, though, that would make you or me or the people following this site feel any safer, any more assured? In large part to specific families providing information re: the deaths of their family members and to specific medical information from Canada and Argentina as to heightened/ intense need for ventilators and the horrific organ damage, we know this virus can be powerful. We know this virus is deadly.

Although yet young, this virus has proven itself capable to go where it wills-and when it wills. It is in my community and it has hospitalized people in my community. And it is doing all this during a time when most flus "take a break".

I, too, have tried finding information so as to provide some balance, a sense of clarity. But so much is happening so fast everywhere. Great Britain presented as slow, Australia took off at a much greater and devastating speed as did Japan. At this point in time, however, there seems to be nothing slowing this virus down or de-escalating it's punch.

90,000 to 450,000 deaths is a daunting concept. And one, I presume, open to revision should virulence and/or CFR increase and/ or appear to increase.
 
Re: Argentina: unusual serious cases in young people

Dark Horse said:
After reading the "lungs-on-fire" translation and internal organs destroyed description from Argentina's doctors on the front line, I feel my heart beat faster. I get scared. Is this something new that the virus is doing? Or is this simply what it has been doing all along, but in keeping with the "mild" mantra embraced by the media in the U.S. and Canada we infrequently hear about. Perhaps the Argentina doctors are simply being candid whereas the North American public health bureaucracies do not feel they can talk freely because of 1) HIPPA-type constraints, or 2) they are so entrenched in their "it's mild" risk communications mantra, that they willfully refuse to tell the truth.

Of course, the fluwatchers look for the new virus' adaptation to its human host which would likely produce more severe infections and more deaths. And I watch closely, read about each death, and still have absolutely no idea about whether this flu is becoming more lethal. I understand how HIPPA makes public officials very conservative about the information they reveal, but why doesn't CDC or some other medical group provide insight about these fatal cases that doesn't compromise the privacy of the deceased so that the public can understand what is really going on around the world?

My only guess is that the groups that are in a position to suspect on the basis of epidemiology that this virus is becoming more lethal as it spreads to larger populations are not interested in sharing that information.
Click to expand...


The risks about hypertoxic influenza infections with pandemic H1N1 were clear since the start.

From May 22 Weekly Epidemiological Record:

Initial WHO guidance on clinical management of human infection with new influenza A (H1N1) virus

Based on the limited clinical information available, and given the evolving situation, WHO advises the following approach to the clinical management of human infection with new influenza A (H1N1) virus.

Mild cases.

Supportive treatment (e.g. paracetamol, fluids) based on symptoms should be provided as needed. Salicylates (such as aspirin and aspirin-containing products) should not be used in children and young adults because of the risk of Reye syndrome. Where antiviral medication is available, early administration in at-risk patients (those with co-morbidities or who are pregnant) with a neuraminidase inhibitor (oral oseltamivir or inhaled zanamivir) is advised. The new influenza A (H1N1) virus is susceptible to neuraminidase inhibitors (oseltamivir, zanamivir) but resistant to M2 ion channel inhibitors (amantadine, rimantadine). Adequate infection control precautions (cough etiquette, hand hygiene and natural ventilation) at home should be implemented.

Hospitalized patients.

Where available, antiviral treatment with oseltamivir is recommended, especially in progressive disease or pneumonia caused by new influenza A (H1N1) virus infection. The findings in severe new influenza A (H1N1)-related pneumonia are similar to those noted in avian influenza A (H5N1) virus infection in humans and, until further data become available, the guidance provided for clinical management of avian influenza A (H5N1) virus infection remains applicable in patients with severe new influenza A (H1N1) virus infection.9
Click to expand...

Respiratory support.

The cornerstone of management is early detection and correction of hypoxia with supplemental oxygen or mechanical ventilation as necessary. Treatment of hypoxia requires close attention to practical issues, including oxygen delivery devices and flow rates, monitoring and patient compliance. When mechanical ventilatory support is indicated, a low-volume, low-pressure lung protective ventilation strategy for ARDS should be used.

Antibiotics.

When pneumonia is present, treatment with antibiotics should generally follow recommendations from published, evidence-based guidelines for community-acquired pneumonia. Antibiotic choices should be based on local data regarding frequency of pathogens related to secondary infections, patterns of resistance and drug availability at country level. Of note, seasonal influenza and previous influenza pandemics have been associated with an increased risk of secondary Staphylococcus aureus infections that may be severe, rapidly progressive, necrotizing and, in some areas, caused by methicillin-resistant strains.

Antiviral treatment.

Detailed information regarding antiviral therapy in these patients is not currently available, but use of oral oseltamivir in those with serious illness or pneumonia may be beneficial. In some hospitalized patients with new influenza A (H1N1) virus infection, delays to initiation of antiviral therapy are likely an important factor in poor outcomes. Among 27 fatal cases in Mexico, the median time from onset of symptoms to initiation antiviral therapy was 8 days (range, 1?26 days).1

Corticosteroids.

Routine use of corticosteroids should be avoided in patients with new influenza A (H1N1)-related pneumonia, and no benefit from treatment with corticosteroids was reported by clinical colleagues in Mexico. Use of corticosterioids in higher doses has been associated with serious side-effects and evidence of increased viral replication in SARS (severe acute respiratory syndrome) and other respiratory viral infections, as well as increased mortality in avian influenza A (H5N1) disease.10


http://www.flutrackers.com/forum/showthread.php?t=105864
Click to expand...


To read carefully, and to better understand both the need of a correct media sources informations to the public, and for a renewed international cooperation in the effort to evaluate other therapeutical strategies.
 
Re: Argentina: unusual serious cases in young people

colormyquilt said:
Dark Horse. The "lungs-on-fire" hit home for me, too; I have had pneumonia three times. Respiratory is apparently my weakness. :)


What I hear you hitting at, again and again, is the unknown re: the lethality and the death rate. Also, that there is a lot more information out there than appears to be provided to the public in general.

What information could be given now, though, that would make you or me or the people following this site feel any safer, any more assured? In large part to specific families providing information re: the deaths of their family members and to specific medical information from Canada and Argentina as to heightened/ intense need for ventilators and the horrific organ damage, we know this virus can be powerful. We know this virus is deadly.

Although yet young, this virus has proven itself capable to go where it wills-and when it wills. It is in my community and it has hospitalized people in my community. And it is doing all this during a time when most flus "take a break".

I, too, have tried finding information so as to provide some balance, a sense of clarity. But so much is happening so fast everywhere. Great Britain presented as slow, Australia took off at a much greater and devastating speed as did Japan. At this point in time, however, there seems to be nothing slowing this virus down or de-escalating it's punch.

90,000 to 450,000 deaths is a daunting concept. And one, I presume, open to revision should virulence and/or CFR increase and/ or appear to increase.
Click to expand...

Japan does not report any death or severe case to date.
 
Re: Argentina: unusual serious cases in young people

The risks about hypertoxic influenza infections with pandemic H1N1 were clear since the start.

From May 22 Weekly Epidemiological Record:

Quote:
<table width="100%" border="0" cellpadding="6" cellspacing="0"> <tbody><tr> <td class="alt2" style="border: 1px inset ;"> Initial WHO guidance on clinical management of human infection with new influenza A (H1N1) virus

Based on the limited clinical information available, and given the evolving situation, WHO advises the following approach to the clinical management of human infection with new influenza A (H1N1) virus.

Mild cases.

Supportive treatment (e.g. paracetamol, fluids) based on symptoms should be provided as needed. Salicylates (such as aspirin and aspirin-containing products) should not be used in children and young adults because of the risk of Reye syndrome. Where antiviral medication is available, early administration in at-risk patients (those with co-morbidities or who are pregnant) with a neuraminidase inhibitor (oral oseltamivir or inhaled zanamivir) is advised. The new influenza A (H1N1) virus is susceptible to neuraminidase inhibitors (oseltamivir, zanamivir) but resistant to M2 ion channel inhibitors (amantadine, rimantadine). Adequate infection control precautions (cough etiquette, hand hygiene and natural ventilation) at home should be implemented.

Hospitalized patients.

Quote:
<table width="100%" border="0" cellpadding="6" cellspacing="0"> <tbody><tr> <td class="alt2" style="border: 1px inset ;"> Where available, antiviral treatment with oseltamivir is recommended, especially in progressive disease or pneumonia caused by new influenza A (H1N1) virus infection. The findings in severe new influenza A (H1N1)-related pneumonia are similar to those noted in avian influenza A (H5N1) virus infection in humans and, until further data become available, the guidance provided for clinical management of avian influenza A (H5N1) virus infection remains applicable in patients with severe new influenza A (H1N1) virus infection.9 </td> </tr> </tbody></table>
Respiratory support.

The cornerstone of management is early detection and correction of hypoxia with supplemental oxygen or mechanical ventilation as necessary. Treatment of hypoxia requires close attention to practical issues, including oxygen delivery devices and flow rates, monitoring and patient compliance. When mechanical ventilatory support is indicated, a low-volume, low-pressure lung protective ventilation strategy for ARDS should be used.

Antibiotics.

When pneumonia is present, treatment with antibiotics should generally follow recommendations from published, evidence-based guidelines for community-acquired pneumonia. Antibiotic choices should be based on local data regarding frequency of pathogens related to secondary infections, patterns of resistance and drug availability at country level. Of note, seasonal influenza and previous influenza pandemics have been associated with an increased risk of secondary Staphylococcus aureus infections that may be severe, rapidly progressive, necrotizing and, in some areas, caused by methicillin-resistant strains.

Antiviral treatment.

Detailed information regarding antiviral therapy in these patients is not currently available, but use of oral oseltamivir in those with serious illness or pneumonia may be beneficial. In some hospitalized patients with new influenza A (H1N1) virus infection, delays to initiation of antiviral therapy are likely an important factor in poor outcomes. Among 27 fatal cases in Mexico, the median time from onset of symptoms to initiation antiviral therapy was 8 days (range, 1–26 days).1

Corticosteroids.

Routine use of corticosteroids should be avoided in patients with new influenza A (H1N1)-related pneumonia, and no benefit from treatment with corticosteroids was reported by clinical colleagues in Mexico. Use of corticosterioids in higher doses has been associated with serious side-effects and evidence of increased viral replication in SARS (severe acute respiratory syndrome) and other respiratory viral infections, as well as increased mortality in avian influenza A (H5N1) disease.10


http://www.flutrackers.com/forum/sho...d.php?t=105864
</td> </tr> </tbody></table>

To read carefully, and to better understand both the need of a correct media sources informations to the public, and for a renewed international cooperation in the effort to evaluate other therapeutical strategies.
 
Re: Argentina: unusual serious cases in young people

ironorehopper said:
The kidney failure is a not unexpected complication because the pneumonia-related coagulopathy and increased loss of fluids through capillars.

Intravascular coagulation, thrombosis, hemorrhages, lowered serum proteins, are quite common in severe infections' patients.

Even in the early H5N1 cases, kidney failures were observed.

So, I think physicians should keep in mind that severe influenza (as well as other viral infection) requires a comprehensive management of patients, with all supportive care needed, with particular attention to coagulation, capillary permeability and kidney functionality.

It is a matter of critical care unit, and thus a triage protocols are needed in order to select patients with most urgent need.

I see how more than six years since the H5N1 panzootics crisis started has not served to prepare better for emergencies even in developed nations.
Click to expand...

Do they use antithrombin in these acute influenza complications with DIC?

Inhibition by antithrombin of cytokine-induced endothelial cell activation in vitro
Mitsuhiro Uchibaa

Institute of Vascular Biology and Thrombosis Research, University of Vienna, Vienna, Austria


Received 27 February 2003; accepted 28 March 2003. ; Available online 17 July 2003.

Abstract
Antithrombin (AT) is the physiological inhibitor of thrombin or other serine proteases of coagulation cascades. AT is also known to regulate inflammatory reactions. To determine whether AT inhibits cytokine-induced endothelial activation, we examined the effect of AT on an increase in endothelial cell adhesion molecules E-selectin and intercellular adhesion molecule-1 induced by tumor necrosis factor (TNF)-α. AT inhibited increase in E-selectin and intercellular adhesion molecule-1 expression induced by tumor necrosis factor-α. AT inhibited neither IκB degradation, nuclear translocation of NF-κB, nor nuclear binding activity of NF-κB. This suggests that AT did not inhibit the NF-κB pathway. AT inhibited physical interaction of p65 with p300, nuclear cofactor of NF-κB. Intracellular levels of cAMP increased by AT. These results suggest that AT inhibits endothelial cell activation by, at least in some part, inhibiting physical interaction of NF-κB with cAMP/p300 by increasing in intracellular levels of cAMP in endothelial cells.
Click to expand...

Anesth Analg 2006;102:1007-1011

Antithrombin Can Modulate Coagulation, Cytokine Production, and Expression of Adhesion Molecules in Abdominal Aortic Aneurysm Repair Surgery
Tomoki Nishiyama, MD, PhD
Department of Anesthesiology, The University of Tokyo, Faculty of Medicine, Tokyo Department fund was used for this study.

Abstract
We investigated the effects of antithrombin on coagulation, fibrinolysis, and production of cytokines and adhesion molecules in abdominal aortic aneurysm repair surgery. Sixteen patients for Y-shaped graft replacement of abdominal aortic aneurysm were divided into an antithrombin group and a control group. In the antithrombin group, 3000 U antithrombin was infused over 30 min before heparin administration and 24 h later. White blood cell counts, platelet counts, prothrombin time ratio, and serum concentrations of antithrombin, polymorphonuclear leukocyte elastase, interleukin (IL)-1?, IL-6, IL-8, tumor necrosis factor-, and adhesion molecules, and variables of coagulation and fibrinolysis were measured before surgery, at the end of surgery, and 1 and 2 days after surgery. The antithrombin concentration decreased in the control group, whereas it increased in the antithrombin group with significant differences between the groups. Prothrombin time ratio, concentrations of d-dimer, thrombin-antithrombin complex, and intercellular adhesion molecule-1 increased only in the control group and polymorphonuclear leukocyte elastase, IL-6, tumor necrosis factor-, and vascular cell adhesion molecule-1 increased in both groups. They were significantly less in the antithrombin group except for intercellular adhesion molecule-1. In conclusion, antithrombin could decrease hypercoagulation and inflammatory activation during abdominal aortic aneurysm surgery, which may decrease adverse events.
Click to expand...
 
Re: Argentina: unusual serious cases in young people

FrenchieGirl said:
It looks like the policy is changing towards more aggressive treatment, viz:

Lungs to be "burned" in hours
There is a seriousness of patients' unusual '

"We're seeing the placement of young patients, between 15 and 50 years with pneumonia, some rapidly evolving towards a gravity which for many is unusual, in which the lung is' fire 'in a matter of hours," said Dr. Jorge San Juan, head of the Department of Intensive Care Hospital Mu?iz.

This has led to patients with these characteristics begin to be treated in an increasingly aggressive. THE NATION As reported yesterday, doctors from the Ministry of Health received the directive to take, from now on, all cases of influenza and potential influenza A (H1N1), with the recommendation to perform chest radiographs for patients with symptoms of fever and fatigue and internal quickly to all suffering from pneumonia.

"Today, it is known that the virus is circulating mass, the attitude we have with patients depends on clinical assessment made by the doctor not to become a serious case. It is not necessary to diagnose laboratory [confirming the new virus infection] to begin treatment, "said Dr. Vilma Savy, Chief of the Respiratory Virus Malbr?n institute.

(...)

Changes in strategies for care of patients arriving with flu tables advanced aiming to be more aggressive: treat, then see what happens; leapfrogging. "This form of serious patient care will change the trend and prevent more deaths and pneumonia, said Dr. John, coordinator of the Emergency Committee of the Ministry of Health Epidemiological Aires.

For severe pneumonia, said San Juan, today patients do not receive empirical antibiotics and antiviral drugs but also does not delay the use of mechanical ventilation. "While generally expect 24 hours to see how it evolves, we do not, and if decompensation quickly reach intubation," said San Juan.

The province of Buenos Aires will, from next week, with rapid diagnostic tests that will discriminate in just 15 minutes by means of swabs, if the person is a carrier of influenza A. Anyway, the final confirmation will institute Malbr?n. The new test will begin before the treatment, health authorities reported ranches.
Click to expand...


IMO in all reports of this thread, openly or between the lines you can read the following important facts regarding the severe course of the Argentina-cases:

They missed to take swabs in these cases (Had there been ILI or atypical ILI ?) in order to check on novel Influenza A at the time of admittance or at the beginning of the illness.

They did not use antiviral treatment, at least not in the early stage of the disease. I guess, they even did not think of Influenza-pneumonia at that time.

They possibly even started antibiotics too late. Time delay between clinical onset of pneumonia and the first dose of antibiotics is a very important factor regarding the case fatality rate (of pneumonia).

They did no x-ray of they did it late. (At the time you can see signs of pneumonia on the chest x-ray the disease already is in an advanced stage. You certainly may hear rales on auscultation prior to x-ray results !)

At the time, a patient needs to be intubated with a tracheal tube and set on ventilator, damage to lung tissue already is on an advanced stage. Then the quite common problems of intensive care medicine (Sepsis, SIRS, kidney failure on so on) no longer are preventable. If you miss your chance in diagnosis and treatment at an early stage of the disease, then there will be a point of no return, no matter what you'll do on your ICU (ventilators, ECMO etc.).
And rapid tests for Influenza A are false negative in 30 to 40 %.​

No ideas --> no tests --> no diagnosis --> no antivirals --> no antibiotics (or at least: any of these too late).

To me, Argentina is more or less a "deja vu" of Mexico in the first days of its novel influenza A-Epidemic.
 
Re: Argentina: unusual serious cases in young people

Your analysis seems very plausible to me as a layman, thank you german-doctor.

There is one thing that makes me scared, when I think of my 2 children: the illness can develop so fast sometimes.

For example the young girl in Canada .

In the Netherlands we have 1 case still in ICU, for several weeks already, a healthy young man, returning from a travel abroad.

Not much details are published, one report stated he was diagnosed having H1N1, after being in hospital for a week.
 
Re: Argentina: unusual serious cases in young people

german-docter said:
IMO in all reports of this thread, openly or between the lines you can read the following important facts regarding the severe course of the Argentina-cases:
They missed to take swabs in these cases (Had there been ILI or atypical ILI ?) in order to check on novel Influenza A at the time of admittance or at the beginning of the illness.

They did not use antiviral treatment, at least not in the early stage of the disease. I guess, they even did not think of Influenza-pneumonia at that time.

They possibly even started antibiotics too late. Time delay between clinical onset of pneumonia and the first dose of antibiotics is a very important factor regarding the case fatality rate (of pneumonia).

They did no x-ray of they did it late. (At the time you can see signs of pneumonia on the chest x-ray the disease already is in an advanced stage. You certainly may hear rales on auscultation prior to x-ray results !)

At the time, a patient needs to be intubated with a tracheal tube and set on ventilator, damage to lung tissue already is on an advanced stage. Then the quite common problems of intensive care medicine (Sepsis, SIRS, kidney failure on so on) no longer are preventable. If you miss your chance in diagnosis and treatment at an early stage of the disease, then there will be a point of no return, no matter what you'll do on your ICU (ventilators, ECMO etc.).
And rapid tests for Influenza A are false negative in 30 to 40 %.
​
No ideas --> no tests --> no diagnosis --> no antivirals --> no antibiotics (or at least: any of these too late).

To me, Argentina is more or less a "deja vu" of Mexico in the first days of its novel influenza A-Epidemic.
Click to expand...
When I saw the jump in cases in Argentina I also thought it was a re-run of Mexico, but Australia has also seen a jump (7 deaths in the past week) and in both countries the flu season is just beginning, so I think it may be more than just late treatment/diagnosis.
 
Re: Argentina: unusual serious cases in young people

Lab results are notoriously slow here in Argentina. With the certain increase in testing wouldn't it seem likely that the doctors had tested and were waiting for results before making the diagnosis?
To give a personal example, I am still waiting for results of a routine biopsy that was performed 3 weeks ago.
 
Re: Argentina: unusual serious cases in young people

Again..the use of the word unusual without much detail...
Source: http://www.plusinformacion.com.ar/nota.asp?Id=7927

Google translation:

Published on: 29/6/2009

San Isidro: Care of the influenza A H1 N1 at the Hospital Central de San Isidro
"The epidemic of Influenza A H1N1 in Argentina is being developed with unusual features"

The disease is a common flu. A high rate of infection and possible serious cases in previously healthy young patients remain on alert to public health authorities. Right now it is necessary to agree on strategies to reduce medical morbidity and mortality of the epidemic. Consultation with health care in the first days of the onset of fever and the early diagnosis of potential respiratory complications is critical in this phase of the epidemic, "says Dr. Carlos Zala, infectologists Hospital Medical Center San Isidro" Dr. Angel Melchor Posse. "

Since the direction of hospital, Dr. Roberto Gonzalez with the Department of Infectious Diseases implemented a protocol of care to avoid these complications.

The protocol aims to identify and treat early respiratory events that might go unnoticed in a conventional examination. Once the patient with signs of complications, a treatment that includes antibiotics, antivirals and possibly a high dose anti-inflammatory, it started in immediately.

Despite the high demand for emergency care at the Hospital, the working group of medical doctors on call and critical area, residents in surgery, head nurses and supervisors has helped implement such a protocol.

The health team of the Hospital Central de San Isidro is satisfied with the results obtained at the time initially to see that the first patients are beginning to get the medical after brief periods of hospitalization.

There is no doubt that the Influenza A H1N1 continue this for the rest of winter and, without doubt, the health system must respond quickly to new scenarios to reduce the impact of disease on the health of the community.
 
Re: Argentina: unusual serious cases in young people

#55: " If you miss your chance in diagnosis and treatment at an early stage of the disease, then there will be a point of no return, no matter what you'll do on your ICU (ventilators, ECMO etc.).
And rapid tests for Influenza A are false negative in 30 to 40 %."


So, isn't the answer an antiviral blanket to all in the infected areas an early answer - who got it last 2 days will be treated automaticaly in time.

The ones who already have it more time have a try after the optimal schedule, and the ones without the virus will drop into themself an box of antivirals preventively - less dangerous than risk to became an serious case without successfull treatment(?).
___

#59:
""The epidemic of Influenza A H1N1 in Argentina is being developed with unusual features"

The disease is a common flu."

What a ...The disease is an UNCOMMON PANDEMIC flu.
 
Re: Argentina: unusual serious cases in young people

tropical said:
#55: " If you miss your chance in diagnosis and treatment at an early stage of the disease, then there will be a point of no return, no matter what you'll do on your ICU (ventilators, ECMO etc.).
And rapid tests for Influenza A are false negative in 30 to 40 %."


So, isn't the answer an antiviral blanket to all in the infected areas an early answer - who got it last 2 days will be treated automaticaly in time.

The ones who already have it more time have a try after the optimal schedule, and the ones without the virus will drop into themself an box of antivirals preventively - less dangerous than risk to became an serious case without successfull treatment(?).
___

#59:
""The epidemic of Influenza A H1N1 in Argentina is being developed with unusual features"

The disease is a common flu."


What a ...The disease is an UNCOMMON PANDEMIC flu.
Click to expand...
The situation in Argentina is well beyond the Tamiflu blanket stage.
 
Re: Argentina: unusual serious cases in young people

niman said:
The situation in Argentina is well beyond the Tamiflu blanket stage.
Click to expand...

I meant an ALL citizens in an area, Tamiflu blanket.

Have the health professionals any positive answer to an efective early treatment of the initialy infected with light/mild first few days or symptoms (the ones without any initial treatment who could find themself as later serious cases), or they will be worldwide treated as "collateral damage percents"?

If the late treatments are the only scientific answer on the fields,
than an preventive autosomministration of Tamiflu during the first days of suspected symptoms seems an better option, or not?

If it will became resistant, it will, at least the ones previously the resistance will try to treat themself.

UNFORTUNATELY - during wroting this post, a FT thread confirmed the world first new pandemic flu Tamiflu resistant case (Denmark) -
- so the above treatments could have a small duration ...

http://www.flutrackers.com/forum/showthread.php?t=113102
 
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